Emeis M, Liesenfeld O, Stephan R, Panzer-Heinig S, Stück B
I. Innere Abteilung der Kinderklinik Wedding, Universitätsklinikum Rudolf Virchow, Berlin.
Dtsch Med Wochenschr. 1994 Jun 17;119(24):875-8. doi: 10.1055/s-2008-1058774.
Within 24 hours of returning from a five-week holiday in Pakistan a 15-year-old girl developed vomiting and massive diarrhoea leading to severe dehydration with hypovolaemic shock. The diastolic blood pressure was no longer measurable and prerenal renal failure occurred with a serum creatinine of 4.4 mg/dl and metabolic acidosis (pH 7.21, base excess-16.9 mmol). Initially treatment consisted of rehydration (day 1: 9280 ml, day 2: 4850 ml). The patient's condition rapidly improved and she had voluminous stools. A concurrent urinary infection due to Klebsiella pneumoniae was first treated with cotrimoxazole. As a new strain of Vibrio cholerae, serogroup O 139, was isolated from stool, treatment was changed to tetracycline (50 mg/kg daily). Regaining a good general state she was transferred to an isolation ward on the 6th hospital day. The isolated cholera organism belongs to a nonagglutinating serogroup which is indistinguishable clinically and epidemiologically from the classical Vibrio strains which cause cholera. Since the end of 1992 this new serogroup has been causing an explosive spread of cholera in Bangladesh and India.
一名15岁女孩在从巴基斯坦为期五周的假期返回后的24小时内，出现呕吐和大量腹泻，导致严重脱水并伴有低血容量性休克。舒张压已无法测量，出现肾前性肾衰竭，血清肌酐为4.4mg/dl，伴有代谢性酸中毒（pH 7.21，碱剩余-16.9mmol）。最初的治疗包括补液（第1天：9280ml，第2天：4850ml）。患者病情迅速好转，大便量多。同时由肺炎克雷伯菌引起的泌尿系统感染最初用复方新诺明治疗。由于从粪便中分离出一种新型霍乱弧菌O139血清群，治疗改为四环素（每日50mg/kg）。在恢复良好的一般状况后，她于住院第6天被转至隔离病房。分离出的霍乱病菌属于一个不凝集血清群，在临床和流行病学上与引起霍乱的经典霍乱弧菌菌株无法区分。自1992年底以来，这个新血清群一直在孟加拉国和印度引发霍乱的爆发性传播。
